Urinary tract infections, or UTIs, are a common experience, affecting 8-10 million people every year. 1 You may be familiar with some of the most common symptoms- burning with urination, and having frequent urges to urinate. But urinary tract infections can cause some surprising symptoms in older adults that you might not know about. Learn how to recognize them here, and what to do when you suspect a urinary tract infection.
What Causes a UTI?
UTIs are caused by bacteria entering your urinary tract and multiplying. This causes inflammation and irritation. Often, the bacteria are the same type found in your intestinal tract- commonly E. coli.
Although this infection is usually in your urethra (the tube from your bladder to the outside of the body), and sometimes bladder, in severe cases it can travel from the bladder to the kidneys as well.
UTIs and Older Adults
In older adults, UTIs are more common. This is for several reasons. In women, changes in the hormone called estrogen have an impact on the balance of good and bad bacteria near the urethra. Urinary tract infections are more common in general in women, but in women age 65 and older, 10% report having an infection in the last year, with 30% of women 85 and older reporting infections each year.2
In men, an enlarged prostate can allow urine to back up and become more stagnant, resulting in infection. For both genders, changes in bladder and pelvic floor muscles can cause urinary retention or incontinence, both of which can cause conditions that allow bacteria to multiply into an infection. This is especially true in older adults due to changes in the immune system as we age.
Additionally, cognitive changes, strokes, and difficulty with hygiene due to confusion and incontinence can increase the risk of infection. And finally, the use of urinary catheters for medical complications is a source of infection as well.
What Are Some Symptoms of UTI?
There are some common symptoms of UTI that can be easily identified. They include:
- Burning or pain with urination
- Blood in the urine
- Cloudy urine
- Foul-smelling urine
- Needing to urinate more frequently (frequency)
- Having an urgent need to urinate (urgency)
- Pain or pressure in the pelvis
- Abdominal pain, side (flank) pain, or lower back pain
- In more severe UTIs, fever, fatigue, and/or vomiting
In older adults, UTIs can have some unexpected symptoms that might not be as obvious. Very often, older adults have no symptoms at all (asymptomatic infection). When they do, a common symptom is confusion. This can sometimes include agitation, falls, and sudden problems with incontinence when making it to the bathroom has never been a problem in the past. The other common symptoms of a UTI might not be present.
You’ve Noticed UTI Symptoms, Now What?
No matter what symptoms you’re seeing, a UTI can be alarming. This is true for both the person experiencing any discomfort and urgency, or for a caregiver dealing with sudden unexplained confusion or aggression.
For mild UTI symptoms, it’s important to continue drinking lots of water and to see your doctor as soon as possible. Uncontrolled UTIs can lead to serious problems. Not only can infection eventually spread to the kidneys and cause damage there, but in a worst-case scenario a severe UTI can lead to a life-threatening condition called sepsis.
If you’ve seen your doctor, it’s important to take all antibiotics prescribed to be sure the infection is eliminated, even if you feel better. If you’re being treated for a UTI and you notice worsening symptoms, it’s important to follow up right away. Your doctor may need to change the treatment prescribed.
For severe UTI symptoms, such as fever, chills, shaking, vomiting, and lethargy or fatigue, a call to 911 or a trip to the emergency room is warranted.
What Can I Do to Prevent a UTI?
Because UTIs cause so many problems, some of them serious, it’s good to try to prevent them in the first place. There are a few steps you can take to try to avoid a UTI:
- Drink plenty of fluids (unless your doctor has asked you to restrict your fluid intake)
- Wipe front to back
- If you use incontinence briefs, be sure they are changed as soon as they are wet
- Women can ask their doctors about vaginal estrogen creams to help restore normal flora balance
- Be sure you are using the bathroom frequently, and as soon as you feel the urge to urinate. Emptying the bladder often reduces UTI risk.
- Wear clothes that are loose and breathable, such as cotton underwear.
- Cranberry juice and a supplement called D-mannose have been suggested to reduce UTI risk.3 You can ask your doctor about adding these to your routine.
A Word About Urinary Catheters
If you use a urinary catheter, it’s especially important to pay close attention to hygiene, and to watch for signs of UTI. Catheters can become a pathway for bacteria to easily enter the urinary tract or bladder. There are three kinds of urinary catheters:
Straight Catheters
Also called “in and out” catheters, this type of catheter is for temporary use. It is used when someone cannot fully empty their bladder on their own. The catheter is inserted into the urethra, urine is emptied from the bladder, and the catheter is removed. With these catheters, it is important to stick to a regular schedule of emptying the bladder and to take steps to avoid contaminating the catheter when using it. Always wash your hands, keep it in the packaging until ready for use, and never reuse a catheter.
Indwelling (Foley) Catheters
These catheters are inserted into the urethra and connected to a bag for continuous drainage. They can be in place for several days to weeks and sometimes longer. Based on your needs, your doctor may recommend changing it out monthly or up to every 12 weeks. Cleaning around the catheter should happen daily. Always wash your hands before touching the catheter. The bag should never be raised above the level of the bladder, because it can cause urine to backflow into the bladder. Be careful to avoid kinking the catheter or tubing. If the urine in the bag ever looks cloudy or smells foul when emptying the bag, it is important to let your doctor know right away.
Suprapubic Catheters
This type of catheter is surgically inserted through the abdomen into the bladder. Caring for it should be done like the indwelling catheter care described above. Always wash hands before touching the catheter, and be sure the skin around the catheter stays clean. If the catheter falls out, a new catheter should be reinserted right away, because the opening can close up. You should contact your healthcare provider for more details if you have not received training on how to do this. To avoid further complications, it may require a trip to the emergency room to correct the problem.
A Final Word on Managing UTIs
By following the above suggestions to avoid UTIs, and contacting your doctor as soon as you notice problems, you can keep your urinary tract healthy and infection-free.
If getting to the bathroom on your own and avoiding accidents is difficult, or keeping up with your personal hygiene is a challenge, considering an in-home caregiver to help with these tasks may help you maintain your urinary tract health as well. Caresify’s professional caregivers are experienced at helping with personal care, mobility, and hygiene, and are available for whatever care needs you may have. You can find out more here, or call 888-799-5007.
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